| NPI | 1174944888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 1151659) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MI 1077777) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2020-07-17 |